Preventitve surgery Nipples On or Off ( confused) ?

Hey all and hope all are well,

Just a quicky. I was DX last Jan, Grade 3, lumpectomy, chemo, rads aged 28.
I am in the process of genetic testing as we have a huge family history of BC & OC.
I intend to have mastectomy with implants but am confused about the nipples. My surgeon said I could have them removed or keep them but I don’t understand what the benefits are of the two options.

My tumour was very near to the nipple but he said as I had clear margins etc I could keep them if I wanted.

Why do some have the nipples removed and others not ?

Also he said I could have implants fitted under the breast muscle as I have fairly small boobs 34 B / C and this would be a good option for me but I’ve read mixed opinions about this type of procedure. Any info or experiences would be much appreciated.

Thanks and BIG HUGS to all,

Mandy xxx

Hi Mandy, I have DCIS and was told that I can’t keep my nipples as the ducts open into the nipples and it would be too risky to keep them.


Hi Mandy,
I was also diagnosed last Jan grade 3 age 34 - had chemo, mastectomy with immediate reconstruction and rads. In May this year, I had elective mastectomy and reconstruction on my healthy breast due to strong family history and genetic issues. I kept both my nipples. I’m not sure of the criteria, I just know my surgeon offered to keep my nipples and | almost bit his hand off in my haste to preserve them if I could-Ha!
Good Luck

ps- I had the tissue expaander implants using the muscle from the back and they look FANTASTIC!!! Am very pleased!

Hi Mandy,
I had DCIS and nipple/ areola was removed.
I did not want the nipple implant (cartiledge is used) as the nipple would be permanantly erect and I didn’t feel comfortable with that. I have recently had a nipple/ areola tattoo done and it looks very good but to be honest, I had got used to having nothing there and if I had my time again, I would have left it alone.

Hi Mandy

I had mastectomy with immediate reconstruction 2 weeks ago. The lump was not far from the nipple so I had mine removed just in case. It’s up to you if you have clear margins that is probably why they have said it’s ok to keep it.

Not sure which recon you have been offered I had the LD flap ( back muscle & implant ) and am 34b really happy with the results. Looks very much like my other breast. Still taking a bit of getting used to, but it’s early days.

Best wishes



it seems to depend on your surgeon. Mine said that as the nipple has all the ducts go into it, ideally it would be removed if they found a lot of DCIS. however, other surgeons e.g. Mark Kissin in Surrey say that there is only a few percent chance of cancer recurring as a result of the nipple being left providing adequate margins exist between where the cancer is and the nipple, and that the cosmetic result is much better if you have reconstruction and keep your nipples. So I don’t know. You can have nipples reconstructed but it is extra surgery and they look a bit fake to me, but then I had a partial mastectomy so I still have both my nipples although one faces in the wrong direction and is a lot bigger than the other one following radiotherapy. And it is also permanently erect.

The joys of breast surgery


I am currently undergoing bi-lateral risk-reducing mastectomy; I chose to have my nipples removed
as this can be a high risk area, my mother’s cancer was in this area. I have had some prosthetic ones made moulded on mine. Not sure if I’ll ever use them. My reconstruction is using expander implants: I am a 34A; the breast surgeon was concerned that implants would be very problematical as I am also thin but we got advice from a plastic surgeon who suggested putting them behind the chest muscle and adding saline over a few weeks and thought that this would be a good option for me. Six weeks down the line I have a neat new breast and am waiting to have the second one done.